Provider Demographics
NPI:1255436861
Name:BROWN, SHIRLEY ROSE (MSW MPH)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ROSE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4024
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-0024
Mailing Address - Country:US
Mailing Address - Phone:810-237-5328
Mailing Address - Fax:
Practice Address - Street 1:806 TUURI PLACE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2465
Practice Address - Country:US
Practice Address - Phone:810-767-5750
Practice Address - Fax:810-768-7512
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801071618104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker